BIVALVULAR ENDOCARDITIS COMPLICATING PREGNANCY - A CASE-REPORT AND LITERATURE-REVIEW

A twenty-nine-year old woman with a history of rheumatic fever and bot h mitral and tricuspid valve prolapse (without cardiac effects on the echocardiogram) presented with Streptococcus viridans infective endoca rditis of both the tricuspid and mitral valves at seventeen weeks' ges tation. Twelve weeks before admission she underwent a dental curettage and received presumably adequate antibiotic prophylaxis. The present case was successfully managed by means of aggressive antibiotic therap y appropriate for endocarditis, with adequate and appropriate monitori ng of minimal inhibitory concentration and peak and trough levels. Thi s case exhibits the appropriate management in the three phases of ther apy for valvular disease, ie prevention, treatment, and subsequent pre vention of sequelae, prior to vaginal delivery in a patient with endoc arditis. The pregnancy resulted in a term vaginal delivery, without ma ternal or fetal morbidity.